A bunion is nothing more than a dislocation of the great toe joint. As this happens, the joint articulates in an abnormal manner which eventually results in eroding of the joint cartilage- otherwise known as “bone on bone”.
Here’s an example of someone who waited too long. They ended up with a large defect in the cartilage of the articular surface on the head of the metatarsal. This is irreversible and results in endstage arthritis.
How do you know when to proceed with surgical correction? Pain is usually the first indicator.
In the example below, you can see the erosions that occurred on the articular surface of the head of the metatarsal. This is irreversible and will lead to long term pain even though the deformity was corrected surgically. They waited too long.